Pituitary Tumors

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What is a Pituitary Adenoma?

A pituitary adenoma, also called a pituitary tumor, is a growth in your pituitary gland. Your pituitary is a small, bean-shaped gland behind your nose at the base of your brain.

Your pituitary helps regulate your body’s hormone levels. A pituitary adenoma can affect the amount of hormones in your body. Too much or too little hormone can impact how you feel and how your body functions.

Are Pituitary Tumors Cancerous?

Cancerous pituitary tumors are extremely rare. Most pituitary adenomas are benign, meaning they are noncancerous.

How Common Are Pituitary Tumors?

Pituitary tumors are one of the most common types of tumors. They are more common in adults, but children can also have pituitary tumors. More women than men have pituitary tumors.

What Causes Pituitary Tumors?

No one knows the exact cause of pituitary adenomas. People with some inherited (genetic) conditions, such as multiple endocrine neoplasia, type 1 (MEN1), seem to have an increased risk of getting these kinds of tumors.

Your doctor may recommend genetic screening for you or your family members if you have one of these conditions.

Types of Pituitary Adenomas

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We categorize pituitary adenomas based on their size and level of hormone production. Some tumors produce hormones while others do not.

Functional Vs. Nonfunctional

Functioning tumors are pituitary tumors that make hormones. They cause different symptoms based on the hormone they make:

  • Lactotroph adenomas produce prolactin, a hormone involved in milk production.
  • Somatotroph adenomas produce growth hormones.
  • Corticotroph adenomas create the hormone Adrenocorticotropic hormone (ACTH). ACTH leads to the production of steroid hormones.

Nonfunctioning tumors do not make hormones. Symptoms of a nonfunctioning adenoma result from their size. As the tumor grows, it can press on your pituitary gland or nearby nerves.

Size

  • Pituitary microadenoma—Microadenomas are tumors less than one centimeter in length. Despite their small size, they can still produce excessive hormones.
  • Pituitary macroadenoma—Macroadenomas are tumors more than one centimeter long. They can be functioning or nonfunctioning. Their larger size may cause pressure on the pituitary gland or nearby nerves.

Pituitary Adenoma Symptoms

Signs of pituitary tumors depend on the size of the tumor and its impact on your hormone production. A tumor can cause either too much of a hormone or too little. Some tumors, particularly those that are small, cause no noticeable symptoms.

Too Many Hormones (Hormone Overproduction)

Signs of too many hormones depend on the specific hormone, but can include several symptoms:

  • Weight loss
  • Muscle weakness
  • Fat increase at mid-section
  • Increased heart rate
  • Increased sweating
  • Enlarged feet and hands

Too Few Hormones (Hormone Deficiency)

Signs of too few hormones range, but can include noticeable symptoms:

  • Increased urine volume
  • Exhaustion
  • Reduction in menstrual periods
  • Unexplained weight gain or loss,
  • Nausea
  • Feeling cold

Pituitary tumors rarely spread. Benign pituitary tumors remain in the pituitary gland or nearby. Most are slow-growing, but as they grow, they can impact the brain and surrounding nerves. Large pituitary tumors can cause more noticeable symptoms:

  • Headaches—Your pituitary tumor may cause you to experience headaches. You may feel pain in your forehead when it puts pressure on your nerves on brain.
  • Vision problems—Your pituitary tumor may cause symptoms with your eyes. You may experience loss of peripheral (side) vision, when it presses on the optic nerve. You may also experience double vision, blurring, or sudden blindness.

Symptoms in Men Vs. Women

Some pituitary tumors increase the hormone prolactin. Prolactin affects sex hormones differently for men and women. Men may experience erectile dysfunction. They may also have reduced sperm count and breast tissue growth.

Women experience other symptoms:

  • Irregular periods
  • A milk-like discharge from the nipples not associated with pregnancy or lactating
  • Breast pain

Find a Pituitary Tumor Specialist

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Pituitary Adenoma Diagnosis

If your health care provider thinks you have a pituitary adenoma, you will need a physical exam and tests:

  • A vision exam — Some tumors can affect the optic nerve affecting both sides and overall vision.
  • Hormone testing — Urine and blood tests can show if you have an increase or decrease of hormones.
  • Imaging — Both magnetic resonance imaging (MRI) and computed tomography (CT) scans can help find a pituitary tumor.
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Pituitary Tumor Treatment

Treatment depends on the type and size of your tumor. Your general health and age play a role in your provider’s recommendation.Some tumors do not need treatment. If your tumor is small and not causing problems, your provider might recommend watching your tumor. This means your provider regularly checks your tumor to see if it has grown or changed.

Radiation

Radiation is a treatment option after surgery or when surgery is not an option. We also treat pituitary tumors that recur (return repeatedly) with radiation. You may receive one dose of radiation or many over time. Your radiation dose is customized to match the shape and size of your tumor.

  • Radiotherapy—This is a multi-step treatment approach over a period of weeks. You will receive more than five doses during treatment.
  • Stereotactic radiosurgery—This type of radiation uses a focused dose of radiation that matches the size of your tumor. Despite its name, this process does not need cutting.

Pituitary Tumor Surgery

Endoscopic/Transsphenoidal

This type of minimally invasive surgery uses a small camera or a microscope to help surgeons see the tumor. Your surgeon does not have to open your skull. They reach the tumor by going through your nose. This method needs no external cuts. 

  • Endoscopic endonasal (or endoscopic transsphenoidal)—Your surgeon uses a long, thin tube called an endoscope to view the tumor. They remove it through your nose and sinuses.
  • Microscopic transsphenoidal--A microscope placed in your nose helps surgeons view the tumor. A neurosurgeon cuts through the sinus wall to reach the tumor and remove it.

Craniotomy

A complicated or large pituitary might need a craniotomy. During a craniotomy, your surgeon removes a small piece of your skull to reach the tumor. They replace the piece of your skull at the end of surgery.

Learn More About Pituitary Surgery

Life After Pituitary Tumor Surgery

It is normal to have congestion and sinus headaches after surgery. Your provider will watch for other, more serious complications. Your risk level may increase for meningitis or other infections.

Your hormone levels may fluctuate. You may need medication if you have a decrease in hormones.

Learn What to Expect With Pituitary Tumor Surgery

Make an Appointment

If you believe you need an evaluation for a pituitary tumor, you can make an appointment with one of our skull base tumor specialists.

No doctor referral is necessary to come visit us, but please check with your insurance first as some insurance companies require referrals.

Get a Consultation

Not located in Utah? You can contact us for a consultation. Once we have scheduled the call, we will set up a phone call to discuss your diagnosis with you. We will also ask you to send us:

  1. Copy of the CD of your MRI images,
  2. Copy of your vision test, and
  3. Any other testing you may have had (endocrinology or other).

Learn More From Our Specialists

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Pituitary Tumors: Your Questions Answered

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Contact the Destination Care Program

The Destination Care Program is an initiative by U of U Health focusing on care for our out-of-state patients. We are here to help you find the services and information you need. Feel free to contact us:

Email: DestinationCare@hsc.utah.edu
Phone: 801-587-6365